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1.
Sci Rep ; 14(1): 13725, 2024 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-38877186

RESUMO

The 2019 coronavirus (COVID-19) can generate acute respiratory distress syndrome (ARDS), requiring advanced management within the Intensive Care Unit (ICU) using invasive mechanical ventilation (IMV However, managing this phenomenon has seen learning and improvements through direct experience. Therefore, this study aims were to describe the assessment of the different IMV variables in patients with post-COVID-19 hospitalized in the ICU and their relation with mortality. Observational and retrospective study. The sample was divided into two, the surviving group (SG) and the non-surviving group (NSG). Clinical data were extracted from the electronic clinical file and the respiratory therapist record sheet. The following information was obtained: Patient medical history: gender, age, co-morbidities, arterial gases, days on IMV, and IMV parameters. Out of a total of 101 patients, the total mortality was 32%. There was a significant decrease in respiratory rate (RR) (29.12 ± 4.24-26.78 ± 3.59, p = 0.006), Driving pressure (DP) (11.33 ± 2.39-9.67 ± 1.84, p = 0.002), Ventilatory rate (VR) (2.26 ± 0.66-1.89 ± 0.45, p = 0.001) and a significant rise in Static compliance (Cest) (35.49 ± 8.64-41.45 ± 9.62, p = 0.003) and relation between Arterial oxygen pressure/Inspirated oxygen fraction (PaO2/FiO2) (201.5 ± 53.98- 227.8 ± 52.11, p = 0.008) after 72 h of IMV, within the NSG compared to the SG. Apart from these points, multi-morbidity (HR = 3.208, p = 0.010) and DP (HR = 1.228, p = 0.030) and VR variables (HR = 2.267, p = 0.027) had more death probabilities. The results of this study indicate that there was a significant increase in RR, DP, VR, and CO2 and a significant drop in Cest and PaO2/FiO2 among the NSG compared with the SG. Apart from this, the DP and VR variables, multi-morbidity and being male. have more possibility of death.


Assuntos
COVID-19 , Respiração Artificial , Síndrome do Desconforto Respiratório , Humanos , COVID-19/mortalidade , COVID-19/complicações , COVID-19/terapia , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Síndrome do Desconforto Respiratório/mortalidade , Síndrome do Desconforto Respiratório/terapia , Idoso , Unidades de Terapia Intensiva , SARS-CoV-2/isolamento & purificação , Adulto
2.
Front Physiol ; 15: 1395855, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38872832

RESUMO

Objective: There is evidence that indicates that the Walked Distance (WD) in the 6-Minute Walk Test (6MWT) would be sensitive to the type of track and encouragement. The aim of study was compared the impact of track type and verbal encouragement provided in the 6MWT on WD, physiological cost, perceived exertion, and gait efficiency in healthy young adults unfamiliar with the test. Method: WD, heart rate, subjective sensation of dyspnea (SSD), and fatigue (SSF) were measured in four 6MWT protocols: i) 30 m linear track and protocolized encouragement (LT + PE), ii) 30 m linear track and constant encouragement (LT + CE), iii) 81 m elliptical track and protocolized encouragement (ET + PE), and iv) 81 m elliptical track and constant encouragement (ET + CE). In addition, the Gait Efficiency Index (GIE) associated with physiological cost, dyspnea and fatigue was calculated and compared between the different protocols. Results: The WD was significantly higher in the ET + CE protocol. The percentage of the heart rate reserve used (%HRRu) at minute 6 was higher in the ET + CE protocol. The SSD and SSD had difference in startup time between the protocols. The GEI was higher in %HRRu, SSD, and SSF for the ET + CE protocol. Conclusion: The ET + CE protocol showed a significant increase in WD during the 6MWT in healthy young adults. Although it obtained the highest physiological cost, it did not present perceptual differences when entering cardiopulmonary assessment windows relevant to a more efficient test for the participant. It is advisable to discuss, based on the findings, the fundamental objective of the 6MWT and national and international recommendations to achieve a result as close as possible to the real maximal effort.

3.
Int. j. morphol ; 42(2)abr. 2024.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1558151

RESUMO

Las unidades de cuidados intensivos (UCI) y agudos han sido los contenedores del avance de la pandemia por COVID-19. Sin embargo, la estadía prolongada en esta unidad puede repercutir sobre la composición corporal (CC) y la capacidad derealizar ejercicio de los pacientes. El objetivo de esta investigación fue determinar si existe relación entre composición corporal (CC) y la prueba de caminata en 6 minutos (PC6m). Se reclutaron 17 personas (8 mujeres y 9 hombres). Se tomaron las siguientes medidas: PC6m, se consideró su distancia recorrida (DRPC6m) y su velocidad (VelPC6m). Las variables de CC medidas fueron índice de masa corporal (IMC), masa grasa (MG), masa libre de grasa (MLG) y masa magra (MM). La DRPC6m sólo mostró relación significativa con la MM corporal (MMC). Por otra parte, la VelPC6m tuvo una relación significativa con la MMC. Además de esto, la MLG del miembro inferior derecho y la MLG del miembro inferior izquierdo mostraron una relación con la VelPC6m (r=0,422; p=0,041 y r=0,417; p=0,025, respectivamente). También la MM del miembro inferior derecho y la MM del miembro inferior izquierdo se relacionaron significativamente con la VelPC6m (r=0,422; p=0,030 y r=0,420; p=0,042). En conclusión, existe relación entre composición corporal y VelPC6m. Esto permitiría aproximarse de manera rápida al nivel de funcionalidad con la que ingresa un paciente a un programa de rehabilitación.


SUMMARY: The intensive care units (ICU) and acute care units have been the containers for the advance of the COVID-19 pandemic. However, prolonged stay in this unit can impact patients' body composition (WC) and ability to exercise. This research aimed to determine if there is a relationship between body composition (BC) and the 6-minute walk test (6mWT). 17 people were recruited (8 women and 9 men). The following measurements were taken: 6mWT, its distance traveled (6mWTDT) and its speed (6mWTS) were considered. The WC variables measured were body mass index (BMI), fat mass (FM), fat-free mass (FFM), and lean mass (LM). 6mWTDT only showed a significant relationship with body LM (BLM). On the other hand, 6mWTS had a significant relationship with BLM. In addition to this, the FFM of the right lower limb and the FFM of the left lower limb showed a relationship with 6mWTS (r=0.422; p=0.041 and r=0.417; p=0.025, respectively). Also, the LM of the right lower limb and the LM of the left lower limb were significantly related to the 6mWTS (r=0.422; p=0.030 and r=0.420; p=0.042). In conclusion, there is a relationship between body composition and 6mWTS. This would allow us to quickly approach the level of functionality with which a patient enters a rehabilitation program.

4.
BMC Geriatr ; 24(1): 313, 2024 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-38575913

RESUMO

BACKGROUND: It is internationally known that our population is aging. At the same time, some patients with COVID-19, due to their symptoms, required mechanical ventilation (MV) and subsequent pulmonary rehabilitation (PR). This study aimed to compare the effects of a multimodal PR program "ADULT" versus "OLDER" people with COVID-19 who were on MV. METHODS: The intervention consisted of an 8-week hybrid PR program (2x week). Forced vital capacity (FVC) was measured at the beginning and end of PR, upper and lower limb strength was obtained through hand grip strength (HGS) and the sit-to-stand test (STST), respectively, and functional exercise capacity was measured with the 6-minute walking test (6MWT). RESULTS: The main results were an increase in the FVC in the ADULT and OLDER groups (time effect, P = 0.000; η2 = 0.27), an increase in HGS in the ADULT and OLDER groups (time effect, P = 0.000; η2 = 0.52), in the same way, the number of repetitions on the STST increased in the ADULT and OLDER groups (time effect, P = 0.000; η2 = 0.55). Finally, the distance covered on the 6MWT increased in the ADULT and OLDER groups (time effect, P = 0.000; η2 = 0.65). CONCLUSIONS: The PR program is an effective strategy to improve FVC, muscle strength, and functional exercise capacity similarly in adults and older people with post severe COVID-19 who required MV.


Assuntos
COVID-19 , Doença Pulmonar Obstrutiva Crônica , Humanos , Idoso , Respiração Artificial , Teste de Esforço/métodos , Força da Mão , Tolerância ao Exercício , Capacidade Vital , Força Muscular/fisiologia
5.
Bioengineering (Basel) ; 11(4)2024 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-38671818

RESUMO

Peri-implantitis is an inflammatory condition characterized by inflammation in the peri-implant connective tissue and a progressive loss of supporting bone; it is commonly associated with the presence of biofilms on the surface of the implant, which is an important factor in the development and progression of the disease. The objective of this study was to evaluate, using micro-CT, the bone regeneration of surgically created peri-implant defects exposed to a microcosm of peri-implantitis. Twenty-three adult New Zealand white rabbits were included in the study. Bone defects of 7 mm diameter were created in both tibiae, and a cap-shaped titanium device was placed in the center, counter-implanted with a peri-implantitis microcosm. The bone defects received a bone substitute and/or a resorbable synthetic PLGA membrane, according to random distribution. Euthanasia was performed 15 and 30 days postoperatively. Micro-CT was performed on all samples to quantify bone regeneration parameters. Bone regeneration of critical defects occurred in all experimental groups, with a significantly greater increase in cases that received bone graft treatment (p < 0.0001), in all measured parameters, at 15 and 30 days. No significant differences were observed in the different bone neoformation parameters between the groups that did not receive bone grafts (p > 0.05). In this experimental model, the presence of peri-implantitis microcosms was not a determining factor in the bone volume parameter, both in the groups that received regenerative treatment and in those that did not.

6.
Anat Sci Int ; 2024 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-38678164

RESUMO

The development of a standard anatomical language in Spanish dates back to the early stages of medicine, and its significance lies in the necessity for a common vocabulary to describe the structures of the human body. Anatomists and morphologists have been striving to achieve this goal since the late nineteenth century when the first Anatomical Nomenclature was created in Basel in 1895. Over the years, various versions of the International Anatomical Terminology have been published in Spanish, following the guidelines of the International Federation of Associations of Anatomists (IFAA). These versions have been produced in partnership with the Spanish Anatomical Society and have aimed to adjust the terms to the Spanish language and linguistic rules. The Ibero-Latin American Symposia on Anatomical, Histological, and Embryological Terminology (SILAT) have embraced the naming of morphological structures, keeping in mind the Latin and Greek roots, while respecting the translations accepted by the linguistic rules of the official languages. These symposia stick to the principles of universality, precision in structure description, and consistency in terminology. Despite more than a century of progress in anatomical terminology, there is a need for frequent revisions and adjustments to anatomical terms, particularly when translating them into various languages and because of the high number of international publications related to anatomy. A shared anatomical language is essential for the study and application of anatomy across various medical practices and in undergraduate education. Finally, the establishment of anatomical terminology in Spanish represents a long history of efforts to create a universal and precise language in this field. Despite advancements, the revision and adaptation of anatomical terms remain a continuous challenge to keep up with scientific progress and ensure effective communication in the field of anatomy.

7.
Ther Adv Respir Dis ; 18: 17534666231212431, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38660953

RESUMO

BACKGROUND: Severe coronavirus 2019 disease (COVID-19) causes acute hypoxemic respiratory failure requiring invasive mechanical ventilation (IMV). Once these symptoms are resolved, patients can present systemic deterioration. OBJECTIVE: The two objectives of this study were as follows: to describe the results of a pulmonary rehabilitation program (PRP), which is divided into three groups with different numbers of sessions (12, 24, and 36), and to associate the variables of pulmonary function, exercise performance, and functionality with the number of sessions and functional improvement. DESIGN: Prospective, observational study. METHODS: PRP consisted of aerobic + strength + flexibility exercises under the supervision and individualized into 12, 24, or 36 sessions (12s, 24s, and 36s), depending on the evolution of each patient. At the beginning of the study and immediately after the intervention, forced vital capacity (FVC), maximal inspiratory pressure, 6-minute walk test (6MWT), sit-to-stand test (STS), maximal handgrip strength (HGS), Fatigue Assessment Scale, Post-COVID-19 Functional Status (PCFS), and health-related quality of life (HRQoL) were measured. RESULTS: The proposed PRP demonstrated a positive effect on pulmonary function, exercise performance, and HRQoL, regardless of the number of sessions. A higher score on the PCFS and more days on IMV were associated with the increased likelihood of needing more sessions, whereas more meters on the 6MWT in the initial evaluation was associated with a reduced likelihood of needing more sessions. Finally, more repetitions on the STS and less distance covered on the initial 6MWT were associated with a greater improvement in exercise performance evaluated with the 6MWT. CONCLUSION: Supervised and individualized PRP for patients with severe post-COVID-19 improves pulmonary function, exercise performance, functionality, and quality of life. Functionality, distance covered on the 6MWT, and the days on IMV are central to the scheduling of the number of sessions for these patients.


Assuntos
COVID-19 , Terapia por Exercício , Qualidade de Vida , Humanos , COVID-19/fisiopatologia , COVID-19/reabilitação , Estudos Prospectivos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Terapia por Exercício/métodos , Pulmão/fisiopatologia , Tolerância ao Exercício , Testes de Função Respiratória , Resultado do Tratamento , Recuperação de Função Fisiológica , Índice de Gravidade de Doença , Fatores de Tempo
8.
Geriatrics (Basel) ; 9(2)2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38525746

RESUMO

To assess ventilatory evolution through the Ventilatory Workload Kinetic Index (VWKI) in patients with asthma and chronic obstructive pulmonary disease (COPD) during stability and exacerbation. Retrospective analysis. Conducted at the Padre Alberto Hurtado Hospital, Santiago, Chile. Ten patients with asthma and fifty-five with COPD participated. Sixty-five clinical records were reviewed. The VWKI in stability and exacerbation of these patients was extracted. When analyzing the baseline with the peak in both asthma and COPD, there was a significant increase in the VWKI. Similarly, the loads, translations, and supports significantly increased from the baseline to the peak. However, in the loads, there were no changes in airway resistance for asthma or in cough for COPD. Likewise, the supports for asthma and COPD showed no changes in the O2. The VWKI determined ventilatory issues in outpatients and made locating the greatest compromise in loads, translations, or supports possible.

9.
Clin Anat ; 37(3): 337-343, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38251059

RESUMO

Almost 20% of the Latin nouns (193/993) in Terminologia Histologica (TH), the international standard nomenclature for human histology and cytology, display linguistic problems, particularly in the areas of orthography, gender, and declension. Some anatomists have opposed efforts to restore the quality of the Latin nomenclature as pedantry, preferring to create or modify Latin words so that they resemble words in English and other modern languages. A Latin microanatomical nomenclature is vulnerable to the criticism of anachronism, so the requirement for the use of authentic Latin, including derivation of new words from Greek and Latin words rather than from modern languages, if possible, may be even greater than it is for the anatomical nomenclature. The most common problem identified here appears to have been caused by derivation of Latin nouns by addition of -us and -um second declension endings to English words. Many Latin nouns (128) in TH contain one of six morphemes that have been treated this way even though the original Greek words are either first declension masculine or third declension neuter nouns. Ironically, deriving Latin nouns directly from Greek morphemes often results in words that look more familiar to speakers of Romance and Germanic languages than those derived indirectly through modern languages (e.g., astrocyte, collagene, dendrita, lipochroma, osteoclasta and telomere instead of astrocytus, collagenum, dendritum, lipochromum, osteoclastus, and telomerus).


Assuntos
Anatomistas , Vocabulário , Humanos , Idioma , Linguística
10.
Clin Anat ; 37(1): 12-24, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37453079

RESUMO

Gamification has appeared as an alternative educational methodology to traditional tools. Specifically, in anatomy teaching, multiple technological applications have emerged in response to the difficulties of accessing cadaveric material; however, there is insufficient information about the effects of these applications on the performance achieved by students, or about to the best way to adapt learning to meet their educational needs. In this study, we investigated how teaching human anatomy through a mobile gamified technological tool containing recommendation systems can be combined with a virtual assistant to improve the learning and academic performance of medical students in the Anatomy Department at the Universidad de La Frontera in Temuco, Chile and the Anatomy Department at the Pontificia Universidad Católica de Chile. In total, 131 students participated in the experiment, which was divided into two case studies. The main findings led to the conclusion that gamified components support students in learning anatomy. In addition, the predictions and recommendations provided by the virtual assistant enabled the academic aspects that the students needed to improve to be extracted adequately. Future work is expected to support adaptive learning by incorporating new artificial intelligence in education elements that can generate personalized scenarios for studying anatomy based on the application.


Assuntos
Anatomia , Educação Médica , Humanos , Gamificação , Inteligência Artificial , Aprendizagem , Poder Psicológico , Anatomia/educação
11.
Int J Mol Sci ; 24(18)2023 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-37762430

RESUMO

The aim was to compare the effect between a single intra-articular infiltration (1i) and two infiltrations (2i) of medium molecular weight hyaluronic acid (MMW-HA) of high viscosity (HV) and low viscosity (LV) on the histopathological characteristics of temporomandibular joint (TMJ) osteoarthritis (OA) induced in rabbits. An experimental study was conducted on Oryctolagus cuniculus rabbits, including 42 TMJs, distributed between (1) TMJ-C, control group; (2) TMJ-OA, group with OA; (3) TMJ-OA-wt, group with untreated OA; (4) group treated with HA-HV-1i; (5) group treated with HA-HV-2i; (6) group treated with HA-LV-1i; and (7) group treated with HA-LV-2i. The results were evaluated using the Osteoarthritis Research Society International (OARSI) scale and descriptive histology considering the mandibular condyle (MC), the articular disc (AD), and the mandibular fossa (MF). The Kruskal-Wallis test was used for the statistical analysis, considering p < 0.05 significant. All treated groups significantly decreased the severity of OA compared to the TMJ-OA-wt group. The HA-HV-2i group showed significant differences in the degree of OA from the TMJ-OA group. The degree of OA in the HA-HV-2i group was significantly lower than in the HA-LV-1i, HA-LV-2i, and HA-HV-1i groups. The protocol that showed better results in repairing the joint was HA-HV-2i. There are histological differences depending on the protocol of the preparation used: two infiltrations seem to be better than one, and when applying two doses, high viscosity shows better results.


Assuntos
Lagomorpha , Osteoartrite , Animais , Coelhos , Ácido Hialurônico , Peso Molecular , Protocolos Clínicos , Osteoartrite/tratamento farmacológico
12.
Pharmaceutics ; 15(9)2023 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-37765158

RESUMO

Based on the qualities of Ulmo honey (Eucryphia cordifolia), a medical-grade honey (Ulmoplus®) has been developed. Relevant to this, the use of copper represents an emerging therapy for the treatment of wounds. Therefore, the aim of this study was to see how this medical-grade honey with copper nanoparticles (CuNPs) helped to heal infected or non-infected wounds. Twenty-four guinea pigs (Cavia porcellus) were divided into four groups for phase 1 (without and with infection, U + F1 and U + F2), and two groups for phase 2 (selected formulation, without and with infection, U + F2NI and U + F2I). Bacteriological and histopathological studies, collagen fibers content evaluation, and stereological analysis were performed. The selected formulation displayed the same antibacterial potency as Ulmoplus®, indicating that this medical-grade honey by itself can be used as an antibacterial agent. However, the evaluation of collagen content demonstrated a significant increase in fibroblast and type III collagen fibers for infected and uninfected groups, which correlated with the histopathological study. Therefore, it is correct to affirm that adding CuNPs to Ulmoplus® improved the maturation of collagen fibers. Finally, polymorphonuclear cells presented similar values between experimental groups, which would indicate that the formulation under study was able to regulate the inflammatory process despite their infectious condition.

13.
Front Vet Sci ; 10: 1172025, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37252390

RESUMO

Introduction: Antibacterial properties of honey vary according to its floral origin; few studies report the percentage of pollen types in honey, making it difficult to reproduce and compare the results. This study compares the antibacterial and wound-healing properties of three kinds of monofloral Ulmo honey with different percentages of pollen from Eucryphia cordifolia. Methods: The pollen percentage of the honey was determined by melissopalynological analysis, and they were classified into three groups: M1 (52.77% of pollen from Eucryphia cordifolia), M2 (68.41%), and M3 (82.80%). They were subjected to chemical analysis and agar diffusion test against Staphylococcus aureus. A total of 20 healthy adult guinea pigs (Cavia porcellus) of both sexes were randomly assigned to four groups for experimental burn skin wound (uninfected) production and treatment with Ulmo honey. On day 10 post-injury, biopsies were obtained, and histological analysis was performed to assess wound-healing capacity following the treatment with honey. Results: The chemical analysis showed that M3 differed significantly from M1 in terms of pH (P = 0.020), moisture (P = 0.020), total sugars (P = 0.034), and total solids (P = 0.020). Both strains of Staphylococcus aureus were susceptible to M1 and M2 at 40% w/v but were resistant to M3 at all concentrations. All groups (I-IV) were in the initial proliferative phase, with complete or partial re-epithelialization of the epidermis. Discussion: The antibacterial activity showed a wide range of variation in the different types of honey studied, with no significant differences between wound healing and pollen percentage in the groups studied. Higher pH and the absence of Tineo in M3 conferred a lower antibacterial capacity but not a lower wound healing capacity. Despite its variability in the percentage of Eucryphia cordifolia like primary pollen in Ulmo's monofloral honey, this has the same properties in relation to wound healing.

14.
Ann Med ; 55(1): 889-897, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-36881045

RESUMO

INTRODUCTION: Patients who suffered severe COVID-19 need pulmonary rehabilitation. Training may be prescribed objectively based on the maximum speed in the six-minute walk test. The objective of this study was to determine the effects of a personalized pulmonary rehabilitation program based on the six-minute walk test speed for post-COVID-19 patients. METHODS: Observational quasi-experimental study. The pulmonary rehabilitation program consisted of 8 weeks of training, twice a week for 60 minutes per session of supervised exercise. Additionally, the patients carried out home respiratory training. Patients were evaluated by exercise test, spirometry and the Fatigue Assessment Scale before and after the eight-week pulmonary rehabilitation program. RESULTS: After the pulmonary rehabilitation program, forced vital capacity increased from 2.47 ± 0.60 to 3.06 ± 0.77 L (p < .001) and the six-minute walk test result increased from 363.50 ± 88.87 to 480.9 ± 59.25 m (p < .001). In fatigue perception, a significant decrease was observed, from 24.92 ± 7.01 to 19.10 ± 7.07 points (p < .01). Isotime evaluation of the Incremental Test and the Continuous Test showed a significant reduction in heart rate, dyspnoea and fatigue. CONCLUSION: The eight-week personalized pulmonary rehabilitation program prescribed on the basis of the six-minute walk test speed improved respiratory function, fatigue perception and the six-minute walk test result in post-COVID-19 patients.KEY MESSAGESCOVID-19 is a multisystem disease with common complications affecting the respiratory, cardiac and musculoskeletal systems.The 6MWT speed-based training plan allowed for increased speed and incline during the eight-week RP program.Aerobic, strength and flexibility training reduced HR, dyspnoea and fatigue in severe post-COVID-19 patients.


Assuntos
COVID-19 , Humanos , Dispneia/etiologia , Dispneia/terapia , Exercício Físico , Teste de Esforço , Fadiga/etiologia
15.
Burns ; 49(2): 261-274, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-35842272

RESUMO

INTRODUCTION: Laser photobiomodulation (laser PBM) is an effective means of accelerating burn wound contraction, however it is still unclear whether laser PBM produces greater benefit when applied directly to excised and unexcised burn wounds . The aim of this systematic review of preclinical studies was to determine the effectiveness of laser PBM in the wound contraction rate in excised and unexcised burn wounds. MATERIALS AND METHODS: A systematic search was conducted in the EMBASE, MEDLINE and LILACS databases. Preclinical studies were included that analysed the effectiveness of laser PBM in burn wound contraction, and assessed wound closure. The SYRCLE risk of bias tool was used. Random effects models were used to estimate the pooled effect. RESULTS: Thirteen studies were included in the qualitative analysis and six in the quantitative analysis. Two weeks after the lesion, laser PBM favoured the wound contraction percentage, increasing the closure rate in excised burn wounds (SMD= 1.34, CI 95% 0.41 to 2.27, 0.41-2.27, I2=0%, =0%, low certainty of evidence. In unexcised burns, it was uncertain whether laser PBM increased or diminished the wound contraction rate (SMD=1.22(SMD=1.22 CI 95% -0.05 to 2.49, I2=68%; =68%; very low certainty of evidence). CONCLUSIONS: In the animal model, laser PBM is effective in increasing the wound contraction rate in excised burns. However, due to the low certainty of the evidence, uncertainty remains about the true magnitude of the effect of laser on wound contraction in animals; our results should therefore be interpreted with caution.


Assuntos
Queimaduras , Animais , Queimaduras/patologia , Cicatrização , Lasers
16.
Medicina (Kaunas) ; 58(4)2022 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-35454353

RESUMO

Background and Objectives: Patients who survive severe COVID-19 require significant pulmonary rehabilitation. Heart rate (HR) has been used as a safety variable in the evaluation of the results of interventions in patients undergoing pulmonary rehabilitation. The aim of this research was to analyse HR during a pulmonary rehabilitation program in post-severe COVID-19 patients who survived mechanical ventilation (MV). The study includes the initial and final evaluations and aerobic training sessions. Materials and Methods: Twenty patients (58 ± 13 years, 11 men) were trained for 8 weeks. A 6-minute walk test (6 MWT) was performed and, subsequently, a supervised and individualised training plan was created. Resting heart rate (RHR), heart rate recovery (HRR), heart rate at minute 6 (HR6 min) and the product of HR6 min and systolic blood pressure (HR6 minxSBP) were measured at 6 MWT. In addition, HR was measured at each training session. Results: After 8 weeks of pulmonary rehabilitation, patients decreased their RHR from 81.95 ± 9.36 to 73.60 ± 9.82 beats/min (p < 0.001) and significantly increased their HRR from 12.45 ± 10.22 to 20.55 ± 7.33 beats/min (p = 0.005). HR6 min presented a significant relationship with walking speed and walked distance after the pulmonary rehabilitation period (r = 0.555, p = 0.011 and r = 0.613, p = 0.011, respectively). HR6 minxSBP presented a significant relationship with walking speed and walked distance after training (r = 0.538, p = 0.014 and r = 0.568, p = 0.008, respectively). In the pulmonary rehabilitation sessions, a significant decrease in HR was observed at minutes 1, 6 and 15 (p < 0.05) between sessions 1 and 6 and at minute 1 between sessions 1 and 12. Conclusions: Eight weeks of individualised and supervised pulmonary rehabilitation were effective in improving RHR and HRR in COVID-19 patients surviving MV. HR is an easily accessible indicator that could help to monitor the evaluation and development of a pulmonary rehabilitation program in COVID-19 patients who survived MV.


Assuntos
COVID-19 , Teste de Esforço , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Respiração Artificial , Sobreviventes , Caminhada
17.
Clin Anat ; 35(4): 526-528, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35218594

RESUMO

Human cadaveric donors are essential for research in the anatomical sciences. However, many research papers in the anatomical sciences often omit a statement regarding the ethical use of the donor cadavers or, as no current standardized versions exist, use language that is extremely varied. To rectify this issue, 22 editors-in-chief of anatomical journals, representing 17 different countries, developed standardized and simplified language that can be used by authors of studies that use human cadaveric tissues. The goal of these editor recommendations is to standardize the writing approach by which the ethical use of cadaveric donors is acknowledged in anatomical studies that use donor human cadavers. Such sections in anatomical papers will help elevate our discipline and promote standardized language use in others non anatomy journals and also other media outlets that use cadaveric tissues.


Assuntos
Anatomia , Doadores de Tecidos , Cadáver , Humanos
19.
Artigo em Inglês | MEDLINE | ID: mdl-34639733

RESUMO

COVID-19 has caused a certain proportion of patients to be hospitalized in intensive care units (ICU) and may cause musculoskeletal and neurological deficits following intubation and mechanical ventilation. The aim of this study was to quantify and describe the presence of shoulder pain in patients released from hospitals after suffering COVID-19. Patients with positive Apley tests were sent to a physiatrist for a clinical evaluation, ultrasound and electromyography (EMG). This evaluation was completed with a pain scale, joint range and shoulder muscle strength evaluations. Of the one-hundred-sixteen patients, seventy eight entered the respiratory rehabilitation program. Twenty patients were sent to the multidisciplinary shoulder team for positive Apley scratch tests. Of these twenty patients, one had only an EMG, ten had only ultrasounds, seven had an EMG and ultrasound and two did not need complementary tests. The twenty patients were sent to the physical therapist, with all presenting pain and diminished joint range and muscle strength in the affected shoulder. In this context, shoulder pain could be associated with the prone position in the ICU. We suggest time control and position change for patients on mechanical ventilation in a prone position with COVID-19.


Assuntos
COVID-19 , Respiração Artificial , Humanos , Respiração Artificial/efeitos adversos , SARS-CoV-2 , Dor de Ombro/epidemiologia , Dor de Ombro/etiologia , Sobreviventes
20.
Photobiomodul Photomed Laser Surg ; 39(7): 439-452, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34264767

RESUMO

Background and objective: To determine the effectiveness of photobiomodulation therapy (PBMT) in the burn wound healing compared with the control or with the use of antibiotics, in animal models. Materials and methods: A systematic search was conducted in EMBASE, MEDLINE, and LILACS databases. Preclinical studies were included that analyzed the effectiveness of PBMT in the burn wound healing, which assessed wound contraction, angiogenesis, proliferation of fibroblasts, and collagen deposition. SYRCLE risk of bias tool was used. Random effects models were used to estimate the pooled effect. Results: Thirty-eight studies were included. PBMT favored wound contraction (mean difference = -11.47, 95% confidence interval -19.87 to -3.08, I2 = 0%; moderate certainty of evidence). PBMT also favored angiogenesis at doses between 11 and 20 J/cm2, and increased the collagenization rate. Conclusions: In animal models, PBMT favored wound contraction, angiogenesis, and collagen deposition in second- and third-degree burn wounds.


Assuntos
Queimaduras , Terapia com Luz de Baixa Intensidade , Animais , Queimaduras/radioterapia , Cicatrização
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